Dr Ronan Collins says HSE should have told doctors first before issuing warning

Prof Michael Barry, the clinical lead for the medicines management programme (MMP), said he thought the news about the stroke-prevention drugs had been communicated to GPs. Photograph: Brenda Fitzsimons

The HSE’s decision to announce through the media that two new stroke-prevention drugs might have been prescribed in the wrong doses have been described as “poor practice at best and unnecessarily alarming to the public”.

News that 4,000 patients may have to have their dosages changed for the drugs Pradaxa and Xarelto was first made public in the
Sunday Business Post
.

Stroke expert Dr Ronan Collins, a consultant in Tallaght hospital, said the HSE’s medicines management programme (MMP) had made the decision without giving doctors a chance to peer review the evidence.

Both doctors and consultants have criticised the manner in which the announcement was made, though Prof Michael Barry, the clinical lead for the MMP, said he thought the news had been communicated to GPs. “The letter that I signed was dated March 5th. It was sent out to GPs and all prescribers. I’m assuming it will get to people today [Monday],” he told RTÉ Radio’s
Morning Ireland
.

Dr Collins said the failure to publish the medical criteria for such an announcement was a “great derogation of scientific standard”.

He urged patients to stay on the two blood thinners, as it was more dangerous to stop than to continue them. He advised patients to check with doctors, pharmacies or prescribers if they were concerned.

“I would have welcomed proper engagement between MMP and stroke physicians, geriatricians, neurologists, cardiologists and GPs to discuss and educate where there are concerns with the use of these new drugs,” he said.

“However, I am concerned the current alarmist approach is most unhelpful to patients with atrial fibrillation and in our battle to prevent stroke, and will unnecessarily and understandably lead to an avalanche of queries and concerns, taking up valuable consultation time.”

He said both Pradaxa and Xarelto had been extensively trialled in very large studies and the trials had shown that they were better than the traditional drug warfarin in stroke prevention. “These newer drugs have less interactions, and are user- friendly and a major advance in our battle to prevent strokes,” he said.